Method and device for treatment of orthopedic fractures

ABSTRACT

A device is provided for the treatment of long bone fractures. The device is affixable to the long bone, providing structural stability to the long bone and the bone fracture. Upon fixation to the long bone, the device substantial prevents movement of the bone fracture when the long bone is subjected to compressive and tensile forces. Additionally, the device substantially prevents movement of the bone fracture when the long bone is subjected to torsional forces.

FIELD OF THE INVENTION

The present invention relates generally to a method and device for thetreatment of orthopedic fractures, and more particularly, to theinternal fixation of long bone fractures.

BACKGROUND OF THE INVENTION

The repair of fractured long bones may be accomplished by the attachmentof bone plates to the injured bone to hold the opposing fractured sidesof the bone in place during healing. Bone plates are generally describedas devices with at least one flattened surface and with holes or groovesfor screws and/or wires situated in or along the main body of the plate,to allow fixation of the flattened surface of the device to the bonesurface. The fixation of the bone plate is intended to hold the bone inplace and achieve union of the bone fragments.

In the treatment of long bone fracture, the bone plate is rigidlyaffixed along the longitudinal length of the long bone to prevent motionbetween the fragments. For example, as shown in U.S. Pat. No. 5,702,399to Kilpela et al., a bone plate is secured to a bone by cables loopedaround the bone.

Upon installation, the external forces applied to the bone plate are notlimited to one particular plane and there may be simultaneous forces inseveral planes. Thus, a plate which is usually flattened on one or moresurfaces will not bear loads equally in all directions and may beadequate to withstand forces in one direction but inadequate towithstand forces in another. For example, a bone plate can adequatelywithstand compressive and tensile forces along its longitudinal length,substantially preventing movement of the bone fracture. However, a boneplate can be inadequate in withstanding torsional forces, allowingmovement of the bone fracture under such loading.

There therefore exists a need for an improved method and device for longbone fracture fixation.

SUMMARY OF THE INVENTION

The present invention provides a device for the treatment of long bonefractures. The device is affixable to the long bone, providingstructural stability to the long bone and the bone fracture. Uponfixation to the long bone, the device substantially prevents movement ofthe bone fracture when the long bone is subjected to compressive,tensile, or bending forces. Additionally, the device substantiallyprevents movement of the bone fracture when the long bone is subjectedto torsional forces.

The device includes a plurality of bone plates affixable to the corticalsurface of a long bone, wherein the bone plates provide longitudinalstability to the long bone and the bone fracture. At least one of thebone plates can be affixed to the lateral side of the bone to increasethe bone fracture stability when the bone is subjected to bendingforces. Additionally, at least one transverse member is affixable to andinterposed between the plurality of bone plates, wherein the transversemembers provide torsional stability to the long bone and the bonefracture.

The bone plates are affixed to the cortical surface of the long bonealong a longitudinal length of the long bone. The bone plates eachinclude a plurality of screw holes extending therethrough for receivinga bone screw. The bone plates are affixed to the bone by passing a bonescrew through the screw holes and screwing into the bone. Alternatively,other known means or mechanisms can be used to attach the plates to thebone.

In one embodiment, the bone plates further include a plurality ofthreaded holes extending therethrough, for the attachment of thetransverse members. The transverse members each include a first end anda second end, the first end and the second end each having a screw holetherethrough for receiving a transverse member attachment screw. Thetransverse members are attached to the bone plates by screwing thetransverse member attachment screw into the threaded holes of the boneplates.

BRIEF DESCRIPTION OF THE DRAWINGS

A more complete understanding of the present invention, and advantagesand features thereof, will be more readily understood by reference tothe following detailed description when considered in conjunction withthe accompanying drawings wherein:

FIG. 1 is a front view of a long bone segment including the device ofthe present invention;

FIG. 2 is a top view of a long bone segment including the device of thepresent invention;

FIG. 3 is a front view of an exemplary bone plate of the device of thepresent invention;

FIG. 4 is a side view of an exemplary bone plate of the device of thepresent invention;

FIG. 5 is a top view of a transverse member of the device of the presentinvention;

FIG. 6 is a sectional view of an end of a transverse member of thedevice of the present invention;

FIG. 7 is a side view of a bone plate of the device of the presentinvention including notched segments for attachment of the hook memberof FIG. 6;

FIG. 8 is a sectional view of a transverse member of the device of thepresent invention;

FIGS. 9 a and 9 b is an adjustable length transverse member of thedevice of the present invention;

FIG. 10 is a front view of a bone plate of the device of the presentinvention including elongated screw holes; and

FIG. 11 is a top view of a long bone segment including the device of thepresent invention having a plurality of bone plates.

DETAILED DESCRIPTION OF THE INVENTION

The present invention provides a device for the treatment of long bonefractures. The device is affixable to the long bone, providingstructural stability to the long bone and the bone fracture. Uponfixation to the long bone, the device substantial prevents movement ofthe bone fracture when the long bone is subjected to compressive,tensile or bending forces. Additionally, the device substantiallyprevents movement of the bone fracture when the long bone is subjectedto torsional forces.

Referring now to the figures in which like reference numerals refer tolike elements, there is shown in FIGS. 1 and 2 the device 10 of thepresent invention. The device 10 includes a first bone plate 12 and asecond bone plate 14, each affixable to the cortical surface of a longbone 16. The bone plates 12 and 14 are affixed along the longitudinallength and about the circumference of the long bone 16, wherein the boneplates 12 and 14 intersect a bone fracture 18. The bone plates 12 and 14substantially prevent movement of the bone fracture 18 when the longbone 16 is subjected to compressive and tensile forces. Additionally, atleast one of the bone plates 12 or 14 can be affixed to a lateral sideof the long bone 16 to substantially prevent movement of the long bonefracture 18 when the long bone 16 is subjected to bending forces.

FIG. 1 shows an anterior-posterior view of bone 16 and FIG. 2 shows acephalad-caudal view of bone 16. It should be understood that thesurgeon or other medical practitioner utilizing device 10 can positiondevice 10 in any desired fashion based on a number of factors such asthe location and type of bone fracture 18. Although the bone fracture 18is shown as a simple fracture, device 10 can be used with all types offractures. Furthermore, device 10 can be used for other procedures (e.g.osteotomy or allograph replacement) or situations in which stability ofa long bone is desired. Device 10 can be made of any suitable materialtypically used in orthopedic applications (metals and alloys, ceramics,polymers, either resorbable or not, and composites). Examples ofmetallic materials include titanium, a titanium alloy, or stainlesssteel. If device 10 is made of a metallic material, the same metallicmaterial can be used for all of the components to avoid galvanic(mixed-metal) corrosion.

The device 10 further includes at least one transverse member 20affixable to the bone plates 12 and 14. The transverse members 20 areaffixed to and interposed between the first bone plate 12 and the secondbone plate 14. The transverse members 20 substantially prevent movementof the bone fracture 18 when the long bone 16 is subjected to torsionalforces.

Referring to FIGS. 3 and 4, the bone plates 12 and 14 each include aplurality of screw holes 22, extending therethrough for receiving bonescrews 24 to be driven into the long bone 16. (See also FIG. 1). Thebone screws 24 can be driven into the long bone 16 at orthogonal oroblique angles to the surface of the long bone 16. The screw holes 22can have any configuration. For example and as is well known, the screwholes 22 can be configured and dimensioned to achieve compression of thefracture as the bone screws 24 are inserted into the long bone 16. Also,the screw holes 22 and the heads of the screws 24 can be threaded sothat locking of the screws 24 to the plates 12 and 14 is achieved. Ifdesired, a combination of the compression and locking screw holes 22 canbe used. Furthermore, the present invention also envisions othermechanisms (e.g. cerclage) for attaching the bone plates 12 and 14 tothe long bone 16.

The bone plates 12 and 14 also can include a second series of holes usedto connect with the transverse members 20. Specifically, the bone plates12 and 14 each include a plurality of threaded holes 26 extendingtherethrough for attachment of the transverse members 20.

Referring to FIG. 5, the transverse members 20 each include a first end28, a second end 30, and an intermediate section 32 therebetween thatpartially spans the circumference of the long bone 16. Transversemembers 20 can be manufactured to have a curvature and/or can be bent bythe surgeon to custom shape for an individual patient. The first end 28and the second end 30 each has a screw hole 34 therethrough forreceiving a transverse member attachment screw 36. A transverse member20 is affixed to the bone plates 12 and 14 by passing the transversemember attachment screw 36 through the screw hole 34 and engaging thethreaded holes 26 on the bone plates 12 and 14. (See also FIG. 1) Atleast one of transverse member 20 is affixed to adjacent bone plates 12and 14, wherein the transverse member 20 span the radial distancebetween the bone plates 12 and 14, providing torsional support to thedevice 10.

The attachment screws 36 can be bone screws which are driven into thelong bone 16. Additionally, the transverse member screw holes 34 can beunthreaded screw holes, configured for receiving bone screws 24, whichare driven into the long bone 16.

Referring again to FIG. 4, the bone plates 12 and 14 include a pluralityof notched segments 38. The notched segments 30 are located along thelength of the bones plate 12 and 14, such that a threaded hole 26 ispositioned within each of the notched segments 38. The notched segments38 are configured for receiving the first end 28 and the second end 30of the transverse members 20, such that the first end 28 and the secondend 30 of the transverse members 20 are recessed within the bone plates12 and 14. The notched segments 38 reduce the overall profile of thedevice 10, allowing the transverse member 20 to be substantially flushwith the top surface of the bone plates 12 and 14.

Referring to FIGS. 6 and 7, the first end 28 and the second end 30 ofthe transverse members 20 each include a hook member 40 for engaging thebone plates 12 and 14. The bone plates 12 and 14 each include aplurality of screw holes 22, extending therethrough for receiving bonescrews 24 to be driven into the long bone 16. (See also FIG. 1). Notchedsegments 42 are located between the screw holes 22, wherein the hookmembers 40 engage the notched segment 42. The hook members 40 eachinclude a set screw 44 for securing the transverse member 20 to the boneplates 12 and 14, wherein the set screw compressably engages the notchedsegment 42 thereby securing the hook member 40 to the bone plate 12 or14.

In an alternative embodiment the set screw 44 also engages the long bone16. The set screw 44 is driven obliquely into the long bone 16 securingthe hook member 40 to the long bone 16 and to the bone plate notchedsegment 42.

Referring to FIG. 8, the first end 28 and the second end 30 of thetransverse member are pivotally connected to the transverse member 20.The pivotal connection has a limited range of motion, maintainingtorsional stability of the device 10. In the instance where the boneplates 12 and 14 are not aligned along the longitudinal length of thelong bone 16, the pivotably connected first end 28 and second end 30allow the transverse members 20 to be affixed to the bone plates 12 and14 without adjusting the position of the bone plates 12 and 14.Exemplary embodiments of transverse members 20 including pivotable endsare provided in U.S. Pat. No. 5,707,372 to Errico et al. and U.S. Pat.No., 5,980,523 to Jackson, which are herein incorporated by reference.

Referring to FIGS. 9 a-b, the transverse members 20 are adjustable. Inthe instances where the distance between adjacent bone plates 12 and 14is not consistent along the longitudinal length of the long bone 16, theadjustable length of the transverse members 20 allows the transversemembers 20 to be affixed to the bone plates 12 and 14 without adjustingthe position of the bone plates 12 and 14. Exemplary embodiments ofadjustable length transverse members 20 are provided in U.S. Pat. No.6,432,108 to Burgess et al and U.S. Pat. No. 5,752,955 to Errico, whichare herein incorporated by reference.

Referring to FIG. 10, the bone plates 12 and 14 each include a pluralityof elongated screw holes 44, extending there through for receiving bonescrews 24 to be driven into the long bone 16. In the instance where thebone plates 12 and 14 are not aligned along the longitudinal length ofthe long bone 16, the elongated screw holes 44 allow the position of thebone plates 12 and 14 to be adjusted to align the bone plates 12 and 14for attachment of the transverse members 20.

In an exemplary embodiment, the bone plates 12 and 14 are semi-rigid,having a malleable conformation, such that the bone plates 12 and 14 canconform to the surface of the long bone 16. Semi-rigid is defined asmeaning that the bone plates 12 and 14 are conformable to the surface ofthe long bone 16, yet the bone plates 12 and 14 retain sufficientrigidity to provide structural stability to the long bone 16 undercompressive, tensile, and bending forces.

Additionally, the bone plates 12 and 14 can be of different sizes. Forexample, when a first bone plate 12 is affixed to a lateral side of thelong bone 16 and the second bone plate 14 is affixed to either theposterior or anterior side of the long bone 16, the second bone platecan have a thickness less than the thickness of the first bone plate 12.

Referring to FIG. 11, which shows a cephalad-caudal view, the device 10of the present invention includes a plurality of bone plate 46. The boneplates 46 are affixable to the cortical surface of a long bone 16 alonga longitudinal length of the long bone 16. The transverse members 20 areconnected to and interposed between adjacent bone plates 46, providingtorsional stability to the device 10.

In an exemplary method of use, the device 10 of the present invention isaffixed to the femur to treat an orthopedic fracture. Initially, accessis gained to the treatment site using procedures and instrumentationknown in the art. For example, percutaneous and other minimally invasiveprocedures can be used. The first bone plate 12 is affixed to thecortical surface of the femur by inserting the bone screws 24 throughthe screw holes 22 and screwing into the femur. The first bone plate 12is affixed to the lateral side of the femur along the longitudinallength of the femur and intersecting the bone fracture 18. The secondbone plate 14 is affixed to the cortical surface of the femur in similarfashion as the first bone plate 12, wherein the second bone plate 14 iscircumferentially offset from and substantially parallel to the firstbone plate 12. The first bone plate 12 and the second bone plate 14substantially prevent movement of the bone fracture 18 when the femur issubjected to compressive and tensile forces.

The transverse members 20 are connected to the first bone plate 12 andthe second bone plate 14, wherein the transverse members 20 are affixedto the bone plates 12 and 14 by passing the transverse member attachmentscrews 36 through the screw hole 34 and engaging the threaded holes 26on the bone plates 12 and 14. For example, a first end 28 of atransverse member 20 is aligned with a threaded hole 26 on the firstbone plate 12 and second end 30 of the transverse member 20 is alignedwith the corresponding threaded hole 26 on the second bone plate 14.Transverse member attachment screws 36 are passed through the screwholes 34 and threaded into the threaded holes 26 on both bone plates 12and 14, securing the transverse member 20 to the bone plates 12 and 14.This is repeated for each of the transverse members 20, until alltransverse members 20 are installed. The transverse members 20 span theradial distance between the bone plates 12 and 14, providing torsionalsupport to the device 10.

While various descriptions of the present invention are described above,it should be understood that the various features could be used singlyor in any combination thereof. Therefore, this invention is not to belimited to only the specifically preferred embodiments depicted herein.

Further, it should be understood that variations and modificationswithin the spirit and scope of the invention might occur to thoseskilled in the art to which the invention pertains. Accordingly, allexpedient modifications readily attainable by one versed in the art fromthe disclosure set forth herein that are within the scope and spirit ofthe present invention are to be included as further embodiments of thepresent invention. The scope of the present invention is accordinglydefined as set forth in the appended claims.

1. An internal long bone fracture fixation device for the treatment of along bone fracture comprising: a plurality of bone plates affixable to acortical surface of a long bone; and at least one of transverse memberaffixable to and interposed between the plurality of bone plates.
 2. Thedevice according to claim 1, wherein the plurality of bone plates areaffixed along a longitudinal length of the long bone.
 3. The deviceaccording to claim 1, wherein the plurality of bone plates substantiallyprevents a longitudinal movement of the long bone fracture.
 4. Thedevice according to claim 1, wherein the plurality of bone plates areconformable to the cortical surface of the long bone.
 5. The deviceaccording to claim 1, wherein the at least one transverse membersubstantially prevents a torsional movement of the long bone fracture.6. The device according to claim 1, wherein the plurality of bone platescomprises first and second bone plates affixed along a longitudinallength of the long bone.
 7. The device according to claim 6, whereineach of the first and second bone plates includes a plurality of screwholes extending therethrough for receiving a bone screw to be driveninto the long bone.
 8. The device according to claim 6, wherein each ofthe first and second bone plates includes a plurality of transversemember attachment holes extending therethrough each configured forreceiving a transverse member attachment screw.
 9. The device accordingto claim 8, wherein first and second ends of each of the at least onetransverse member have a screw hole therethrough for receiving atransverse member attachment screw.
 10. The device according to claim 9,wherein the transverse member attachment holes are threaded holes. 11.The device according to claim 9, wherein the transverse memberattachment screws are bone screws.
 12. The device according to claim 9,wherein each of the first and second bone plates includes a plurality ofnotched segments, such that each of the plurality of transverse memberattachment holes is positioned within a notch segment.
 13. The deviceaccording to claim 9, wherein the first and second ends are pivotallyconnected to the transverse member.
 14. The device according to claim 6,wherein first and second ends of each of the at least one transversemember include a hook member for engaging the first and second boneplates.
 15. The device according to claim 14, wherein the hook membersare pivotally connected to the first and second ends of the transversemembers.
 16. The device according to claim 1, wherein the transversemembers have an adjustable length.
 17. An internal long bone fracturefixation device for the treatment of a long bone fracture comprising:first and second bone plates affixable to a cortical surface of a longbone along a longitudinal length of the long bone; and a plurality oftransverse members affixable to and interposed between the first andsecond bone plates, wherein the plurality of transverse memberssubstantially prevent a torsional movement of the long bone fracture.18. The device according to claim 17, wherein the first and second boneplates each includes a plurality of screw holes extending therethroughfor receiving a bone screw to be driven into the long bone.
 19. Thedevice according to claim 18, wherein the first and second bone plateseach includes a plurality of threaded holes extending there through. 20.The device according to claim 19, wherein first and second ends of thetransverse members each have a screw hole therethrough for receiving atransverse member attachment screw threadable into the threaded holes ofthe first and second bone plates.
 21. The device according to claim 20,wherein the first and second bone plates each includes a plurality ofnotched segments, such that each of the plurality of threaded holes ispositioned within a notch segment.
 22. The device according to claim 20,wherein the first and second ends are pivotally connected to thetransverse members.
 23. The device according to claim 17, wherein firstand second ends of each of the transverse members include a hook memberfor engaging the bone plates.
 24. The device according to claim 23,wherein the hook members are pivotally connected to the first and secondends of the transverse members.
 25. The device according to claim 17,wherein the transverse members have an adjustable length.
 26. Aninternal fracture fixation device for the treatment of a long bonefracture comprising: first and second bone plates affixable to acortical surface of a long bone along a longitudinal length of the longbone, the first and second bone plates each including a plurality ofscrew holes extending therethrough for receiving a bone screw to bedriven into the long bone, and a plurality of threaded holes extendingtherethrough; and a plurality of transverse members affixable to andinterposed between the first and second bone plates, the transversemembers each including first and second ends, the first and second endseach having a screw hole therethrough for receiving a transverse memberattachment screw threadable into the threaded holes on the first andsecond bone plates, wherein the first and second bone platessubstantially prevent longitudinal movement of the long bone fractureand the plurality of transverse members substantially prevent torsionalmovement of the long bone fracture.